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pamigill Asked November 2019

My mother has advanced dementia. She has not seen her doctor for over a year. She is not getting medical attention due to her behavior?

My mother’s behavior is getting difficult to manage. She refuses to take any medicine. She has not seen her doctor for over a year. She is very frail and does not comply with requests. She is surviving mostly on Ensure or banana a day. Her sleep patterns are very inconsistent. Sometimes sleeping for 36 hours and then awake for 12 -15 hours. She is becoming difficult to manage. She fell twice but then did not allow people to check out the wounds on her elbows. I am completely at a loss. She lives with my dad and has help for 10-15 hours. How can I get medical help to stabilize her mood? How to protect the care takers when she injures herself from a fall and refuses help? Lately, she is not going to the bathroom and after much struggle has started using pull ups. But she refuses to change it when wet or soiled. She will hit or scratch you. My dad wants to keep her at home. My dad is not in his best health either. He is recovering from cancer. I don’t live with them or in the same state. Any suggestions?

Geaton777 Nov 2019
BarbBrooklyn gives good advice from experience. It's good you see the need for action, but maybe it's more than to "stabilize her mood" as dementia is not mood in the way we understand it... it is less about rational emotion and more about a broken brain. She has dementia and there is no cure for that, and she is getting more physical. She may need Memory Care.

Who has durable PoA for her? Hopefully someone other than your dad. If no one has PoA, this means another course of action (guardianship). Does she have a Medical Directive? Do you know if your parents have financial means? This may determine where they get their care going forward. It is possible to place them in the same care community, where your dad is in an area that is appropriate for him and your mom is in an area where she will get what she needs. They will have full access to each other. Also, please try to have her tested for a UTI as it can worsen existing dementia symptoms. And if possible have both your parents sign a HIPAA waiver from their doctors' offices so that they can freely and legally exchange their medical information and status with you. Wishing you a smooth and speedy solution to help your parents!

EllenSW Nov 2019
I had the same issue with my dad... became irate when I tried to take him to his regular physician. I used Drs Making House Calls and within minutes of the Drs arrival they were sitting in the den chatting like old friends. It worked perfectly. Now when he checks in on dad it's like a friend dropping by to visit!

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BarbBrooklyn Nov 2019
This must be heartbreaking and scary for you. Your father is in grave danger of predeceasing your mom due to the stress of caregiving.

Of course he wants to keep her home. BUT does he listen to reason that she may need to go somewhere to get stabilized?

The next times she falls or attempts to injure someone, dad (and the caregivers) should be instructed to call 911 and have her transported to the ER for evaluation. While there, someone needs to get the social work department involved in getting her admitted for a psych workup to get her stabilized on meds.

Alternatives are to look into an involuntary psychiatric hospitalization (called Baker Act in some states).

There are also senior behavioral units in some locations. Has her doctor been contacted and does s/he have any ideas?

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